Online ISSN: 2515-8260

Drain fluid amylase in pancreatic surgeries as a predictor for early drain removal and associated complications

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Abhijit Patra1 , Jishan Ahmed2 , Siddhartha Sankar Konwar3

Abstract

Background: Diagnostic accuracy of drain fluid amylase as a triage test for the detection of clinically significant pancreatic leaks, so that an informed decision can be made as to whether the patient with a suspected pancreatic leak needs further investigations, treatment and also a predictor for early drain removal and help in enhanced recovery after surgery. Aims And Objective: To analyze the drain fluid amylase (DFA) on the 3rd Post-operative day (POD) as a predictor for early drain removal and its associated complications. Methodology: Patients admitted to our hospital and after a detailed history and investigations those who were diagnosed with carcinoma head of the pancreas, periampullary carcinoma, chronic pancreatitis, and underwent pancreatoduodenectomy and Lateral pancreaticojejunostomy patients were analyzed prospectively. Twenty cases were taken into the study. DFA analysis was done on Day 1 and Day 3. Those patients without drains or POD 1 DFA >5000 U/L were excluded. Patients with POD 1 DFA <5000 U/L were divided into groups based on POD 3 DFA: Group A (<350 U/L) and Group B (>350 U/L). Analysis of postoperative pancreatic fistula, bile leak, chyle leak, enteric leak, length of hospital stay, and readmission was done. Results: Among 20 patients in the database. Patients with POD 1 DFA <5000 U/L, Group A on POD 3 DFA <350 U/L (12 cases) & Group B with DFA >350 U/L (8 cases). Complications like Postoperative pancreatic fistula, bile leak, chyle leak, and length of hospital stay were more in Group B with a p-value <0.05. Conclusion: Patients with POD 1 < DFA 5000 U/L, and POD 3 DFA < 350 U/L had been good predictor’s early drain removal with minimal complications.

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